The quality measures were updated on the CMS Nursing Home Compare Web site with data from Quarter 3, 2007, in January. AFMC will mail the updated NHQI facility table and graphs in early March. Click here to view your current facility information.

Based on the updated quality measures, Arkansas has continued to show improvement in reducing the use of physical restraints. However, Arkansas remains the worst-ranking state for use of restraints. Quarter 3, 2007, data indicates Arkansas has 11.0% physical restraint usage compared to the national average of 5.09%. Click here to view trending graphs on the four selected NHQI quality measures and to see how our state ranks in them.

The Arkansas Accord encourages long-term care providers to adopt person-directed care principles, more commonly referred to as "culture change." It is your local resource to help get you started by addressing perceived regulatory barriers that might impede your culture change success. Tip sheets have been created to highlight the intent behind adopting certain change ideas and the regulations that support these changes. Click here for more information.

As chair for the Arkansas Accord, AFMC will participate in regional training on "Person-Directed Care: Treasuring Our Cultured Pearls." March 4 will be the first opportunity to attend this informative and motivational program. Click here for details.

STAR (Setting Targets - Achieving Results): Remember to re-set your STAR goals on an annual basis. Please visit the Web site or call the NHQI team if you need assistance with resetting your goals. Setting targets is one of the Advancing Excellence Campaign priorities and can be useful in tracking your quality improvement progress. www.nhqi-star.org/

Arkansas is 100% enrolled in the Advancing Excellence Campaign, showing that our state's nursing homes are dedicated to quality. Click here for resource material, and use your NHQI quality measure graphs or STAR graphs to track your progress toward the campaign goals.

Resources now available on online:
Facility Training Toolkit Program
Click here to access the in-service training documents on 11 different topics, including the four state required in-services.
January 2008 Revision Table for the CMS's RAI Version 2.0 Manual
MDS OBRA Assessment Scheduling Tool for 2008.

Arkansas Innovative Performance Program (AIPP) Monthly Conference Call Minutes
Click here to read minutes from past calls.

Disease management is a systemic approach to improving health care for people with chronic disease. Health care can be delivered more effectively and efficiently if patients with chronic diseases take an active role in their own care, and if providers are supported with the necessary resources and expertise to better help their patients manage their illness. A wide range of disease management tools and resources are available at www.medqic.com. Click on home health, then scroll down under agency- wide improvement to disease management.

Beginning in December 2007, two additional quality measures have been publicly reported on the Home Health Compare Web site ( www.medicare.gov/hhcompare ), for a total of 12 quality measures. The new quality measures include:

Percentage of patients whose wounds improved or healed after an operation.

Percentage of patients who need unplanned medical care related to a new wounds or wounds that have worsened or become infected.

Reducing Acute Care Hospitalization and Emergent Care Use through Home Health Disease Management: A Springfield, Illinois, agency shares its success story in reducing ER use and repeat hospitalizations. Read more.

MedQIC Tool Sharing: If you have developed a tool or strategy that has advanced the quality of care in your organization, be sure to share it nationally through MedQIC. Don't be shy, share your success -- it will help your colleagues. Click here for more information.

IHI - 5 Million Lives Campaign Office Hour Calls feature brief presentations at the beginning of the call and reserve the majority of the hour for answering questions and offering advice. All office hour calls are free, do not require preregistration, and will be recorded and posted to the bottom of this page within a week of the call. For more information and a schedule of calls and topics, click here.

Be sure to check out the new Abstraction Help document - Point of Origin - Data Element found on the public site of Qnet. This document gives several good examples for each of the values allowable for abstraction of this element. Click here.

The Arkansas Critical Access Hospital Patient Safety Program's Web site ( www.arpatientsafety.com) was developed by The Arkansas Department of Health, Office of Rural Health and Primary Care, and Arkansas Foundation for Medical Care to support Critical Access Hospitals in Arkansas. The Web site features: safety alerts; a calendar with state, national and international events; success story submission; Q & A's; free patient safety tools that can be adapted for your facility; training opportunities; links to patient safety articles; and other resources.

CFC Inhalers being phased out: Many people who use inhalers containing the drug albuterol will need to change their inhalers by the end of this year. For more information click here.

March is National Nutrition Month -- a great time to promote nutrition in your workplace. Read more about National Nutrition Month here. Order nutrition tools for patients at no cost at www.afmc.org.

Co-payments and Mammography Rates: A new Brown University study shows that even small health insurance co-payments have a big effect on mammography rates. Rates for receiving these critical breast cancer screening exams were 8 percent lower in plans requiring co- payments compared with plans with full health insurance coverage. Read the article here.

Cultural Competency Training: The Office of Minority Health at the U.S. Department of Health and Human Services invites you to participate in their new continuing education course, "Culturally Competent Nursing Care: A Cornerstone of Caring." This program, accredited for nine CNEs by the American Nurses Credentialing Center's Commission on Accreditation, is available online at no cost to participants at www.thinkculturalhealth.org.

Health Information Technology Update: The Commonwealth Fund, a New York-based foundation, issued a report analyzing 15 policy options for the federal government that could reduce national spending on health care by as much as $1.5 trillion over 10 years - even after spending more than $200 billion to provide health coverage for all Americans. The essential reform is to adopt technology that would allow information to be shared among all the doctors and institutions that care for a patient, lessening the chances of errors and duplication and encouraging better coordination of treatment. More information available here.

The national push for better and more widely used e-health records is suffering from a lack of focus on the doctors who provide the bulk of health care -- primary care physicians -- in the view of doctors affiliated with the American Academy of Family Physicians. Read more.

The National Ambulatory Medical Care Survey, United States, 2006, released in February 2008. revealed that approximately 29.2% of office-based physicians reported that they used an EMR system. However, only 12.4% of physicians used EMR systems with all four of the features considered necessary for a minimally functional system. MMWR data available here.

ACP calls for change: The American College of Physicians has called on the presidential candidates to support a plan to boost the U.S. health care system, which includes an increase in public investment in health IT. According to an ACP report, none of the 2008 presidential candidates' proposals will "avert an impending collapse of primary medicine in the United States." Details available here.

Referrals and consultations are an important part of patient care, but they present numerous challenges. Communication with your patient and with the consulting physician is key to ensuring that these things happen. This article discusses how to make referrals and consultations run smoothly for everyone involved. Click here to read.

Patients like EHRs: With more and more family physicians trying to decide whether to move to an electronic health records (EHR) system and which system to choose, Family Practice Management repeated the survey of user satisfaction with EHR systems that was conducted in 2005. The survey questioned 422 family physicians on user satisfaction with EHRs. Read further about the survey and results here.

E-Prescribing Update: This inaugural annual report prepared by SureScripts is an at-a-glance summary of key statistics detailing the status of e-prescribing in the U.S. The report includes a detailed analysis of variables that influence e-prescribing and concludes with a series of recommendations on how to accelerate e-prescribing adoption and use. Read report.

Sincerely,

Arkansas Foundation for Medical Care

E-mail: qualitybrief@afmc.org

Phone: 1-877-375-5700

Web: http://www.afmc.org